| NPI | 1053136606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: FL 34110) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: GA PTA005280) |
| Enumeration Date | 2024-11-19 |
| Last Update Date | 2025-10-19 |